Analysis Of Risk Factors And Nursing Countermeasures For Ventilator Associated Pneumonia In Neurosurgical Intensive Care Unit

Objection: to understand the occurrence situation of Ventilator Associated Pneumonia(VAP) patients with mechanical ventilation in NSICU of a certain tertiary hospital in Xinjiang province and analyze VAP pathogenic bacteria in NSICU, discuss risk factors of VAP occurs as well as the relationship between VAP and various factors, in order to provide a reference for further proposed nursing countermeasures which correspondingly prevent and control occurrence of VAP in NSICU.Methods: This study adopts the design method of retrospective case-control study, retrospectively analyzed the clinical data of 150 patients with mechanical ventilation treatment who were selected from January2014 to December 2014 in NSICU of a certain tertiary hospital in Xinjiang, patients with ventilator-associated pneumonia(n=50) as the Case group, no ventilator-associated pneumonia(n=100) as a control group, compared the difference of related risk factors between two groups, adopted the single factor test and logistic regression analysis.Results:1.In 150 patients with VAP 50 cases, the incidence of VAP was 33.33%;33 cases occurred in 150 cases of patients with death, the mortality rate of VAP was 22.000%,50 patients with VAP were killed in 23 cases, the mortality of VAP was 69.70%.2.Analysis of pathogenic bacteria: 50 cases of patients with a total of 115 strains of pathogenic bacteria detection detected in 50 patients with VAP were 43 strains, accounting for 86.0% of the total number of VAP, including mainly with klebsiella pneumoniae. The top three, respectively is: with klebsiella pneumoniae.Acinetobacter baumannii. Staphylococcus aureus. The separation of VAP pathogenic bacteria in our study is given priority to with gram-negative bacilli, followed by gram-positive coccus.3.Correlation Analysis: Mechanical ventilation time, GCS score, Apache II score, supine, anti acid agent,sedatives, blood albumin values, lien gastric tube have significant correlation with ventilator-associated pneumonia.4.Multivariate logistic regression analysis: A total of 8 related factors effect in NSICU ventilator-associated pneumonia: the odd ratio of the days of tracheal intubation, state of consciousness, Apache II score, supine,anti acid agent, sedatives, albumin values, gastric tube, they are 1.157, 0.862, 1.987, 480, 27.104 and 1.032,0.705 and 10.239(P < 0.05), with significant statistical significance; the days of tracheal intubation, Apache II score, supine, anti acid agent, tranquilizers, indwelling gastric tube for risk factors, and consciousness,albumin value may be the protective factors.Conclusion: Morbidity and mortality of VAP in NSICU were higher. Independent risk factors of affecting VAP occurs in NSICU respectively were gas insert the number of days, state of consciousness, APACHE‖,supine, antacids, tranquilizers, albumin value, indwelling stomach tube. NSICU patients with mechanical ventilation should reduce time of mechanical ventilation, choose the suitable artificial airway and author proposed that pathogenic bacteria should reasonably choose the anti-infective medicine in order to reduce the occurrence of VAP.